Pro-abortionists use flawed study in challenging Texas pro-life law now before the Supreme CourtBy Randall K. O’Bannon, Ph.D. NRL Director of Education & Research
With the Supreme Court about to hear oral arguments in the case of a 2013 Texas pro-life law, it is no surprise to see pro-abortionists citing the result of a study they say backs up their claims about the law’s dire consequences, particularly about wait times to get abortions.
But the question is not whether they would contest any and all pro-life laws–of course they would.
Apropos their claims in Whole Woman’s Health v. Hellerstedt, the real question is do abortion clinic safety laws increase wait times and delay abortions? Are they the cause of abortion clinic closures? Do they drive women to pick up abortion drugs on the black market or push women into more dangerous second trimester abortions?
These are common complaints lodged by representatives of the abortion industry whenever clinic regulations or hospital admissions privileges are considered or passed by state legislators. With respect to Texas and HB 2, these claims, based on a study that appeared late last year, are now being recycled in multiple briefs as the abortion industry makes its case in the media and the courts.
Let’s examine that research brief, “Abortion Wait Times in Texas: The Shrinking Capacity of Facilities and the Potential Impact of Closing Non-ASC Clinics,” a product of the Texas Policy Evaluation Project (TxPEP). It is being trumpeted in recent state “Truth Tours” sponsored by the abortion industry. 
Are these claims true? If you take the time to study the study, you see that it makes unwarranted assumptions and relies on flawed or incomplete data, raising serious questions about its validity. It also acts as if the very changes it laments had not already started long before HB 2 was passed.
In 2013, the Texas legislature passed a series of laws, popularly known as HB2. It protected pain capable unborn children from abortion (never challenged by pro-abortionists), ensured that abortion clinics meet the basic safety standards of other ambulatory surgical facilities, and required that abortionists have hospital admission privileges at a nearby hospital in cases of botched abortions.
Abortion activists took to the media and to the courts, complaining that the laws were unnecessary and would close many of Texas’ clinics. And while that played out, reliably pro-abortion academicians at the TxPEP did their part, supposedly documenting the dire effects of the new laws.
We have addressed and rebutted in earlier editions of the NRL News Today the claims of one of their research briefs, that between 100,000 and 240,000 women have self-aborted in Texas. As we noted, if there is an increase, it is the result of the abortion industry’s incessant promotion of chemical abortifacients, not pro-life laws.
As for this more recent study, it claims that wait times for abortion appointments increased with passage of the law, reaching as high as 20 days at Dallas, Ft. Worth, and Austin.
Researchers for TxPEP say that if more clinics close, wait times in those cities could increase to the point that the number of second trimester abortions in the state would nearly double, from about 6,600 in 2013 to a projected 12,400 a year once the law reached full effect.
In the group’s press release, Daniel Grossman, one of the lead investigators for TxPEP and one of the country’s most active abortion researchers from the notorious abortion academy University of California, San Francisco (UCSF), expressed his concern. “The increase in second-trimester abortion is concerning from a public health perspective,” said Grossman, “since later abortions, although very safe, are associated with a higher risk of complications compared to early abortions. Later abortion procedures are also significantly more costly to women” (TxPEP release, 10/5/15).
The devil in the details
The TxPEP briefing goes into some detail, noting the wait times they were given over an 11 month period (November 2014 – September 2015) when they anonymously called one of the state’s operating abortion clinics representing themselves as women seeking appointments for first-trimester abortions.
Charts note fluctuations in average wait times for clinics in some of the state’s larger cities. Houston, where Planned Parenthood has a massive abortion megaclinic, and San Antonio, where there are three large clinics (and Planned Parenthood is constructing a new megaclinic of its own), saw no real increase in wait times over the study period. Wait times in Dallas, and Ft. Worth saw increases that appeared to correspond with the closure of one abortion clinic in Dallas and another stopping offering abortion in Ft. Worth.
Wait times in Austin peaked, dropped, then peaked again with no identified obvious reason. There were no charts, but wait times in El Paso and McAllen were never more than 8 days.
TxPEP researchers claim on the basis of these numbers that wait times would increase if clinics failing to meet the state’s new ambulatory surgical center (ASC) standards were to close. And these increased wait times, they project, would have the result of pushing about 5,700 women into more dangerous second trimester abortions.
TxPEP says that there were 34 clinics open when they began making calls and 18 when they published their results in October. Seven clinics closed between April and July 2013, prior to the law’s July 2013 passage and the initiation of the study. Six more clinics would be expected to close in major metropolitan areas , TxPEP claims, if currently operating abortion clinics which are unable to meet the state’s new ASC standards shut down.
Not so fast…
This level of detail, however, ignores some critical contexts and masks some serious limitations in the data that call into question some of the study’s basic conclusions.
Wait times vary, yes, over time, as old clinics close and others open And yes, a fair amount of clinics have closed in Texas in recent years, some perhaps in response to the new state regulations.
But note, clinics were closing before the state passed its new law, and abortions were declining in Texas for years before the latest mandates were passed, reducing the demand overall for Texas clinics.
TxPEP makes much of the reduction of clinics from 41 in April 2013 to 18 in October 2015. As already noted, many of those closures happened before the law passed in July of 2013 and several of the others before the law actually took effect (some portions became operational in October of 2013, others not until September of 2014; different sections of the law were enjoined and enforced over the study period as appeals made their way through the courts).
Perhaps those closures were in anticipation of the law’s enforcement, with the industry not wanting its clinics exposed to inspection. But there is a simpler explanation.
In a 2006 fact sheet, Guttmacher says that there were 65 “abortion providers” in Texas in 2000, meaning that clinics there had already declined by more than a third before the law passed. This is part of a larger national trend. Guttmacher found 2,918 “providers” in the U.S. in 1982, but only about 59% that many in 2011, when it found 1,720.
There are many reasons for that – the retirement of abortionists due to age, their mounting disgust at the bloody nature of their business, the public unpopularity of their practice, etc. But one major factor is simply the reduction of demand. There were 1.6 million abortions performed a year in1990. In the most recent figures from Guttmacher, 2011, there were just over 1 million.
Clinics are closing because business is drying up.
Guttmacher says there were over 110,000 abortions performed in Texas in 1981. They had dropped by more than a third by 2011, when Guttmacher recorded 73,200.
The loss of a caseload that large could not help but affect clinic business. Some of the clinics that depended on abortion had to close. Passage of the law put the spotlight on older, smaller, more dilapidated facilities and abortionists with limited practices not connected to their local medical communities, and this may have hastened some closures and retirements, but these were far from the only causes.
What about the claim that such laws lead to more later abortions? There is little evidence of any increase in 2nd or 3rd trimester abortions in recent years, in spite of the protestations of groups like TxPEP that new laws would push women into later abortions. According to the U.S. Centers for Disease Control (CDC), abortions at greater than 13 weeks gestation have gone down, not up, since 1998 (probably earlier – earlier CDC charts break gestational dates down differently), pointing to their being fewer, not more of these later abortions since the advent of various pro-life laws.
Unable to imagine a world without abortion
At one point, TxPEP admits that its projections on increasing wait times are based on assuming “if demand for services remained constant…”. In spite of the aforementioned evidence–that demand for abortion is dropping in Texas and nationwide–TxPEP assumes for the purposes of its study that demand will remain constant.
It never seems to occur to them that attitudes toward abortion are changing and that, relieved of the pressure and the immediate presence of an abortion clinic, many women have been, and will be, choosing to let their babies live.
For example, not too long ago researchers at UCSF were citing a study of women “turned away” from getting abortions because they were past a given clinic’s gestational limit (clinics lacked the equipment or abortionists with the training to handle abortions at later developments).
While some of the women in that study ended up going elsewhere and getting their abortions, many (despite originally being very much inclined to abortion) made the decision to go ahead and bear their child once their initial request was turned down.
According to that study, within a week of their being “turned away,” a third were no longer willing to say that abortion was the right decision. And more than eight in ten were living with the baby after birth, with the majority reporting their relationships were “good” or “very good” (“Takeaways from the UCSF “Turnaway” Study, 1/9/13, NRL News Today).
The point is that when women do wait, when they are not rushed into an abortion that they cannot “undo,” even many of the most “abortion-minded” change their minds.
The abortion industry and its researchers have always invested too much hope in the market remaining as it is.
The industry endures
Anyone expecting the abortion industry to happily accept its demise is sadly mistaken. This study itself is evidence of its determination to fight back to restore the industry to the old status quo where it simply went about its deadly business without question or confrontation.
They obviously hope to win Whole Woman’s Health v. Hellerstedt. But the industry is not placing all its hopes in the judicial basket. For some time, groups like Planned Parenthood have been shutting down their old, small-town store front clinics. They are replaced with giant new, high volume megaclinics, sporting not only the latest designer colors and hues, but also built to meet state codes for ambulatory surgical centers.
Planned Parenthood opened its 75,000 square foot Houston clinic in 2010. Planned Parenthood used the occasion of the passage of HB2 to raise money for megaclinics being built in both San Antonio and Dallas (Mother Jones 8/28/14).
Whole Woman’s Health, a plaintiff in the case now before the Supreme Court, took the opportunity of the media’s presence during the industry’s big recent Texas “Truth Tour” to show off the spacious, tidy, decorated examination rooms of its San Antonio clinic, packed with the latest medical equipment (San Antonio Express-News, 2/9/16).
It was obviously part of an effort to have people forget the health and sanitation violations at Whole Woman’s Health clinics that helped prompt Texas legislators in the first place to pass many of the sort of regulations the court is now considering (see NRL News Today 4/24/13).
The implicit and sometimes explicit promotion of abortion pills and other herbal abortifacients on the black market (see NRL News Today 9/30/14) is also part of an strategy to try to convince elected pro-life representatives that laws are pointless and that abortion cannot be stopped. However the closure of clinics and the decline in the number of abortions prior to the passage of HB2 demonstrate otherwise.
Talking up self-abortion may mean more women buy these dubious drugs and are exposed to serious health threats, but nothing seen thus far seems to show this happening on a scale sufficient to spawn a large new underground abortion economy (see NRL News Today 11/20/15).
Pro-lifers who have been around a while have learned to expect to see the abortion industry trot out pro-abortion academics predicting public health catastrophes whenever a new pro-life law protecting mothers or their unborn children has passed. This is clearly the case with this latest study from TxPEP.
But in Texas, as we have seen elsewhere, the real effect of these laws has been to see more lives saved, and more mothers spared the agony of abortion.
Source: NRLC News